Spousal Violence in 5 Transitional Countries: A Population-Based Multilevel Analysis of Individual and Contextual Factors

Objectives. I examined the individual- and community-level factors associated with spousal violence in post-Soviet countries.Methods. I used population-based data from the Demographic and Health Survey conducted between 2005 and 2012. My sample included currently married women of reproductive age (n = 3932 in Azerbaijan, n = 4053 in Moldova, n = 1932 in Ukraine, n = 4361 in Kyrgyzstan, and n = 4093 in Tajikistan). I selected respondents using stratified multistage cluster sampling. Because of the nested structure of the data, multilevel logistic regressions for survey data were fitted to examine factors associated with spousal violence in the last 12 months.Results. Partner’s problem drinking was the strongest risk factor associated with spousal violence in all 5 countries. In Moldova, Ukraine, and Kyrgyzstan, women with greater financial power than their spouses were more likely to experience violence. Effects of community economic deprivation and of empowerment status of women in the community on spousal violence differed across countries. Women living in communities with a high tolerance of violence faced a higher risk of spousal violence in Moldova and Ukraine. In more traditional countries (Azerbaijan, Kyrgyzstan, and Tajikistan), spousal violence was lower in conservative communities with patriarchal gender beliefs or higher financial dependency on husbands.Conclusions. My findings underscore the importance of examining individual risk factors in the context of community-level factors and developing individual- and community-level interventions.Understanding factors that contribute to intimate partner violence (IPV) is essential to reducing it and minimizing its deleterious effect on women’s functioning and health. Most evidence comes from studies conducted in western industrialized countries or in the developing countries of Africa, Latin America, and Asia1–5; there is scarce knowledge available on IPV in the transitional countries of the former Soviet Union (fSU) region,6 which represents different geopolitical, socioeconomic, and cultural environments.7 Studies from other countries often demonstrate mixed findings regarding key risk factors for spousal violence, which suggests that their effects are context specific.8–11 An examination of cross-country similarities and differences within the fSU region may contribute to the understanding of risk factors for spousal violence in a different sociocultural context.As a part of the Soviet Union for approximately 70 years until its collapse in 1991, the fSU countries shared similar sociopolitical contexts,12 with a legacy of well-established public services, stable jobs, and high levels of education dating back to the Soviet era.13 The political turmoil and economic crisis of the 1990s following the collapse of the Soviet Union and the transition from a socialist to a market economy resulted in high unemployment, deterioration of public services, and growth in poverty and social inequalities, which increased family stress.14My study focused on 5 countries of the fSU that included an additional Domestic Violence (DV) module in the Demographic and Health Survey (DHS), which presented the first opportunity for cross-country comparison in this region using recent nationally representative data. The DHS survey was conducted in 2 Eastern European countries of the fSU (Moldova and Ukraine) and 2 countries located in the Central Asian region (Kyrgyz Republic and Tajikistan); the Caucasus region was represented by Azerbaijan. Previous DHS and other nationally representative studies from the fSU region included only individual-level predictors of violence without examining the role of contextual factors and focused predominantly on Eastern European countries of the fSU.8,15–17Despite shared Soviet background, the 5 countries differ in terms of gender norms and current socioeconomic situations (7 Eastern European countries (Ukraine and Moldova) share relatively more egalitarian gender norms, whereas Azerbaijan, Tajikistan and Kyrgyzstan, which are secular Muslim nations, have more traditional values and conservative norms. Women in Kyrgyzstan fall in the middle because of a historically large Russian-speaking population.18–21 Nevertheless, Azerbaijan, Kyrgyzstan, and Tajikistan—where the female literacy rate is close to 100% and polygamous marriages are illegal22—differ from many countries with a traditional Muslim culture because of a history of socialistic ideology, suppression of religion, and universal public education. Although Azerbaijan and Ukraine have exhibited significant economic growth because of rich energy resources, Moldova remains one of the poorest countries in Eastern Europe,23 and Tajikistan maintains the status of the poorest republic in the entire fSU region.

TABLE 1—

Selected Country-Level Indicators for 5 Former Soviet Union Countries: 2005–2012

	Eastern Europe		Caucasus	Central Asia
Country-Level Indicators	Moldova	Ukraine	Azerbaijan	Kyrgyzstan	Tajikistan
Population (in millions)	3.6	45.5	9.5	5.9	8.2
Official language(s)	Romanian	Ukrainian	Azerbaijani	Kyrgyz, Russian	Tajik
Area, km2	33 846	603 500	86 600	199 951	142 550
Country’s income category	Lower middle	Lower middle	Upper middle	Lower middle	Low
GNI per capita, Atlas method, US$	2 470	3 960	7 350	1 210	990
Human development index	0.663 (medium)	0.734 (high)	0.747 (high)	0.628 (medium)	0.607 (medium)
Female adult literacy, %	99	100	100	99	100

Open in a separate windowNote. GNI = gross national income; USD = United States dollars.Source: World Development Indicators, World Bank, 2013.Several theories explain IPV through single factors: poverty-induced stress,24 weakened impulse control because of substance use,25,26 or learned aggressive or victimized behavior from the family of origin.27,28 Feminist theorists, however, have argued that poverty, stress, and alcohol abuse do not explain why violence disproportionally occurs against women. Instead, feminist theories suggest that IPV results from historical power differentials by gender, which have been reinforced through male superiority, authority, and socialization.29–32 However, feminist theory alone does not explain why people act differently, even if they grew up in the same social environment and were exposed to similar gender norms.33 Thus, Heise’s ecological model of IPV,33 adopted by the World Health Organization (WHO) as a guiding framework, and modified by Koenig et al.,4 combines individual theories explaining IPV and emphasizes the importance of contextual-level factors.Empirical studies in the United States, Bangladesh, Colombia, and Nigeria demonstrated that certain communities—not just individuals or families—are affected by IPV more than others, positing that violence might be a function of community-level characteristics and attitudes, and not only individual beliefs and behaviors.5,34–36 Community socioeconomic development, domestic violence norms, and community-level gender inequalities might shape individual women’s experiences.4,5 Inclusion of community-level variables might change the effects of individual factors, exemplifying the importance of conducting a 2-level analysis.4,5,34,35Thus, I examined the role of individual-level factors (socioeconomic status, family risk factors, and women’s empowerment status within the household) and contextual factors (community poverty and women’s empowerment status at the community level) associated with current spousal violence in population-based samples in 5 fSU countries: Azerbaijan, Moldova, Ukraine, Kyrgyzstan, and Tajikistan. More specifically, I aimed to examine whether contextual factors had an effect on spousal violence, above and beyond women’s individual-level characteristics, and whether effects remained significant while adjusting for individual and contextual factors simultaneously.